Impacto oncológico de la resección transuretral de vejiga completa antes de la quimioterapia neoadyuvante en el cáncer de vejiga músculo invasor

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-04-01 DOI:10.1016/j.acuro.2025.501712

C. Fernandes , I. Baptista , M. Manso , C. Ferreira , F. Botelho , J. Silva , C. Silva , L. Vale

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Abstract

Objectives

To assess the impact of cTURBT on pathologic response. Secondary endpoints involved survival and oncologic outcomes.

Methods

Tertiary centre data from patients with MIBC submitted to NAC and radical cystectomy between March 2010 and November 2022 was retrospectively analysed. Patients with complete resection (cTURBT) before NAC were compared to those with incomplete (iTURBT).

Results

Thirty-seven patients were included in this study. NAC regime was identical between groups. cTURBT group demonstrated a higher rate of downstaging than the iTURBT group (50% vs 20%, p = 0.022). During the mean 49-month follow-up period, overall survival (86.4% vs. 40%, p = 0.005), relapse-free survival (81.8% vs. 46.7% p = 0.036), and cancer-specific survival (90.9% vs 60%, p = 0.042) were higher in the cTURBT group. Furthermore, we observed significantly fewer relapses, higher survival rates, and lower oncological-related deaths in patients who exhibited downstaging.

Conclusion

cTURBT demonstrated a favourable impact on patients with MIBC undergoing NAC, enhancing pathologic downstaging and improving survival outcomes. Our results can be confounded by cTURBT being a proxy for less aggressive disease.

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新辅助化疗前经尿道切除整个膀胱对侵入性膀胱癌的肿瘤影响

目的探讨ctturt对患者病理反应的影响。次要终点包括生存和肿瘤预后。方法回顾性分析2010年3月至2022年11月期间接受NAC和根治性膀胱切除术的MIBC患者的中心数据。NAC前完全切除（ctturt）的患者与不完全切除（iTURBT）的患者进行比较。结果37例患者纳入本研究。各组间NAC状态相同。ctturt组的降期率高于iTURBT组（50% vs 20%, p = 0.022）。在平均49个月的随访期间，ctturt组的总生存率（86.4% vs. 40%, p = 0.005）、无复发生存率（81.8% vs. 46.7% p = 0.036）和癌症特异性生存率（90.9% vs. 60%, p = 0.042）更高。此外，我们还观察到，表现出低分期的患者复发更少，生存率更高，肿瘤相关死亡率更低。结论cturbt对MIBC行NAC的患者有良好的影响，增强了病理降期，改善了生存结果。我们的结果可能会被ctturt作为侵袭性较低疾病的代表而混淆。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.